Individual
TERESE AILEEN O'NEIL SELVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MN, CNP
Contact information
Practice address
1160 CAMINO DE CRUZ BLANCA, SANTA FE, NM 87505-4584
(505) 984-6418
(505) 984-6918
Mailing address
PO BOX 6880, SANTA FE, NM 87502-6880
(505) 216-0332
(505) 982-0279
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R36675
NM
363LF0000X
Family Nurse Practitioner
CNP00790
NM
Other
Enumeration date
09/21/2006
Last updated
01/17/2024
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